Als also encourages N.I.C.U. doctors and nurses to ensure that the babies experience long periods of near-complete darkness. At Children’s Hospital, when doctors or nurses aren’t working with a baby, the baby’s incubator is covered with a blanket to give it a chance to sleep. Als has explained to her colleagues that the babies are far more aware of their surroundings than the doctors and nurses had thought. When she and I toured the N.I.C.U., she made that point for me by gingerly lifting the corner of one of the blankets. The baby inside the incubator reacted immediately — his breathing became less stable and he shifted his position, even though he hadn’t opened his eyes. ”He knows we’re peeking,” she said.
In 2003, Als and a dozen colleagues reported on the effectiveness of a treatment program that requires doctors and nurses to deliver food and care on a schedule that gives the infants more time to rest, relax and sleep. The care was organized around the needs of the individual infants and families, instead of the work schedules of the doctors and nurses. The findings were remarkable. The babies moved more quickly from intravenous to oral feeding. They spent less time in the N.I.C.U. and had fewer infections, better motor skills and a better ability to focus their attention. They grew faster. And their families displayed less stress and had better relationships with their children. The study provided ”clear evidence for the effectiveness of individualized developmental care,” the researchers concluded.
In a follow-up study last year, Als and her team studied the brain development of premature kids and found further evidence of enhanced brain function and structure in children in the individualized program. There were more neural connections, and those connections more closely paralleled the wiring that would have developed if the babies had remained in the womb for nine months.